Hepatitis B virus (HBV) causes acute and chronic hepatitis and hepatocellular carcinoma. Although a preventive vaccine is available, the therapeutic options for chronically infected patients are limited. It has been shown that RNA interference can prevent HBV gene expression and replication in vivo when HBV expression vectors are delivered simultaneously with small interfering RNA (siRNA) or siRNA expression constructs. However, the therapeutic potential of siRNAs to interrupt ongoing HBV replication in vivo has not been established. Here, we show that expression of HBVspecific siRNAs in the liver of HBV transgenic mice by recombinant adenoviruses can suppress preexisting HBV gene expression and replication to almost undetectable levels for at least 26 days. These results demonstrate that efficiently delivered siRNAs should be able to silence HBV in chronically infected patients.adenovirus vector ͉ RNA interference C hronic hepatitis B virus (HBV) infection causes Ͼ1 million deaths each year due to cirrhosis of the liver and hepatocellular carcinoma (www.cdc.gov͞hepatitis and www.who.int͞ mediacentre͞factsheets͞fs204͞en). Hence, there is a need for alternative ways to treat this persistent infection. RNA interference (RNAi) has rapidly emerged as a technology for regulating mammalian gene expression because it provides a means of sequence-directed degradation of specific RNAs (1-8). In the case of HBV, published in vivo hydrodynamic transfection studies have shown that simultaneous delivery of HBV expression plasmids and HBV-specific small interfering RNAs (siRNAs) (or siRNA-expressing constructs) to the mouse liver can prevent the induction of HBV gene expression and replication (9-11). To expand on those studies, we have examined the therapeutic potential of RNAi for the treatment of chronic HBV infection where ongoing viral gene expression and replication are established in the liver before siRNA delivery.Several variables that have not been previously addressed could affect the utility of RNAi for the treatment of an ongoing HBV infection. First, in the context of an established infection, viral RNAs may be protected within complexes or nucleocapsid structures as has been reported for hepatitis D virus (1), Rous sarcoma virus (12), and respiratory syncytial virus (RSV) (13). This is particularly relevant to HBV, which replicates in capsids after encapsidation of the viral pregenomic RNA. A second variable is how efficiently preexisting viral RNA can be reduced and to what extent RNA suppression can block viral DNA replication. Finally, established viral gene expression may allow for the induction of viral RNAi-defense mechanisms as reported for plant viruses (14) and flockhouse nodavirus (15).It has been shown that RNAi is capable of reducing mammalian gene expression in vivo. Genes such as fas (16), caspase-8 (17), agouti-related peptide (18), tyrosine hydroxylase (19), and ras (20, 21) have been targeted for degradation in mice, and corresponding changes in phenotype were observed. Yet, the actual degree o...